[Analytical study of the silhouette: the segmental syndromes and therapeutic options]

Many studies showed we have a visceral adipose tissue and a subcutaneous adipose tissue. Roles and risks of these fats are different. The purpose of this work is to demonstrate that there are at least two types of subcutaneous fat; one is "metabolic" and diet sensitive and another genetic which is diet resistant. The distribution of subcutaneous fats is also determined by genetic factors, and its study led to the description of segmental syndromes whose distribution and evolution were studied in women in our environment. It seems that no fundamental studies have been made on these two types of fat. We think there is also a genetic programming of our weight which varies with age. This programming may be modulated by the environment (physical activity, diet) but always on a temporary basis. In recent years, the surgical treatment of obesity by gastric rings or by gastric bypass was right to cite, while liposuction is still considered as an accessory process, reserved for purely cosmetic indications. In light of the above, we review the preventive and therapeutic indications of this technique.